Charles Gaba's blog

 

Even as I'm typing this, there's an important hearing going on by the U.S. House Ways & Means Committee regarding pathways towards a universal healthcare coverage system.

Witnesses:

The New Mexico Office of the Superintendent of Insurance website just posted the preliminary 2020 insurance rate filings. Here's the full list, which includes a mish-mash of Individual Market, Large Group and Small Group Market policies, with a Pediatric Dental standalone plan thrown in as well.

It's worth noting that the NM carriers are being very careful to separate out on & off-exchange policies into separate listings even though they're all part of the same risk pool, and they're even separating out off-exchange "Mirrored" policies, which refers to CSR Silver Switching; this is a very good thing.

I've cleaned up the listings and plugged in the weighted average rate increases in the table below this one:

 

via Delaware Business Now:

Legislation calls for reinsurance program to aid people with extremely high health insurance premiums

Lawmakers have introduced legislation this week that would create a reinsurance program to help lower the cost of premiums for Delawareans who do not get insurance through their employers.

House Bill 176, which has no Republican co-sponsors, would stabilize the individual health insurance market and help Delawareans struggling with extremely highhealthcare costs to get relief, a release from House Democrats stated.

Last week I noted that Pennsylvania is joining Nevada, New Mexico, New Jersey and (apparently) Oregon in moving away from the federal ACA exchange mothership known as HealthCare.Gov:

Pennsylvania moves to take over health insurance exchange

Pennsylvania is moving to take over the online health insurance exchange that’s been operated by the federal government since 2014, saying it can cut health insurance costs for the hundreds of thousands who buy the individual Affordable Care Act policies.

...The bill is backed by Gov. Tom Wolf, a Democrat, and his administration says it would make two important changes to reduce premiums for the 400,000 people who purchase health insurance through the Healthcare.gov online marketplace.

A week or so ago I reported that New Jersey is moving forward with fourteen bills related to protecting, repairing and improving the ACA at the state level...including several related to the state's transitioning to their own full state-based ACA exchange.

Today, Lilo Stainton of the New Jersey Spotlight reports that while things are proceeding smoothly for the most part, at least one of the bills is causing a few concerns:

Earlier today I noted that RateReview.HealthCare.Gov, which is a public-facing searchable database for annual health insurance policy premium rate changes, has gone through some updates on the ACA-Compliant side.

I also noted that the other section of the database, which tracks non-ACA compliant rate changes for "Transitional Plans" and "Student Plans", may have had some updates as well, but it's hard to say since I've poked around there so rarely. This morning I decided to rectify that by searching through the entire Transitional/Student plan database and compiling the results. Unlike the ACA side, there's no way of filtering it out by year, so the following table includes every rate change filing entry listed...and the results surprised me:

Warning: There's perhaps 100 people on the planet who'll have any interest in this post. Fortunately, most of those 100 people read this site regularly.

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease. There are hundreds of insurance carriers nationally, with dozens of forms apiece, some of which follow no hard formatting guidelines, and most of which are revised at least once over the course of the spring, summer and fall before being locked in for the upcoming open enrollment period. It's a pretty imposing task.

Regular readers know that I occasionally write freelance blog posts for healthinsurance.org.

In my latest post, I revisited a project which I originally took a crack at last year: Attempting to track every action or legislation introduced, voted on, passed, signed and implemented by every state to protect, repair and/or improve the Affordable Care Act.

At the time I was trying to list the actual legislation and every change in status from start to finish (including bills which died in committee, faile in one house or the other, were vetoed, etc). I quickly discovered that it was next to impossible to keep up with all of that.

This time I took a simpler approach--I only list bills or executive orders which have either been fully approved/implemented or which are pending/in progress. I do plan on going back to updating the spreadsheet, however.

As I noted the other day, some of my blog posts don't have any insight to add, they're purely for aggregating data points. This is one of those posts.

Here's the Connect for Health Colorado May enrollment dashboard report. It doesn't provide much detail, and it's kind of fuzzy/hard to read, but I do like the way it shows both QHP selections (that is, how many people selected exchange policies) as well as effectuated enrollments from month to month.

Remember, around 10% of those who select plans never end up actually paying the first month's premium, and are thus never actually enrolled...and there's some amount of churn after that as people drop their coverage mid-year and new people enroll via Special Enrollment Periods. Then the whole process starts over again the following January.

As a result, you see a gradual divergence between QHP selections increasing and effectuated enrollments decreasing throughout the year...only to reset in January of the next year.

Over the past year or so I've written numerous entries about Michigan Republicans pushing through an ineffective, inefficient, cruel and pointless work requirement addition to Michigan's implementation of Medicaid expansion under the Affordable Care Act, culminating in this one:

New work requirements for people in Michigan's Medicaid expansion group could cause as many as 183,000 people to lose their coverage.

Anywhere between 9 and 27 percent of the approximately 680,000 people enrolled in the Michigan Healthy Plan - or 61,000 to 183,000 recipients - could be kicked of the rolls.

That's up to three times what was estimated by the House Fiscal Agency when the work requirement bill was passed last year. The work requirements are scheduled to take effect on January 1, 2020.

Sometimes I don't have anything particularly useful to add to a data point. New Hampshire is one of the very few states which don't operate their own ACA exchange which does keep track of (and, more importantly, report) ACA exchange enrollment on a regular basis, via a monthly report.

New Hampshire enrolled 44,581 people in individual market QHPs during open enrollment this year, so the 40,728 enrolled as of May shows an impressive 91% retention rate.

Their SHOP enrollment is around ~1,300 people working for ~230 small businesses.

Last night I wrote a long entry noting that Pennsylvania, which has a Democratic Governor but a Republican-controlled state legislature, is taking swift action today to pass a bill allowing PA to establish their own state-based ACA healthcare exchange:

Pennsylvania is moving to take over the online health insurance exchange that’s been operated by the federal government since 2014, saying it can cut health insurance costsfor the hundreds of thousands who buy the individual Affordable Care Act policies.

New legislation unveiled Tuesday has high-level support in Pennsylvania's House of Representatives, with the chamber's Republican and Democratic floor leaders as the bill's lead co-sponsors.

A House committee vote was scheduled for Wednesday, underscoring the urgency of the legislation.

The bill is backed by Gov. Tom Wolf, a Democrat, and his administration says it would make two important changes to reduce premiums for the 400,000 people who purchase health insurance through the Healthcare.gov online marketplace.

Until now there's only been one state which started out hosted by HealthCare.Gov which has gone on to break off onto their own platform: Idaho, which made the move with no drama back in 2014

In Idaho's case, this was always the plan from the start; they simply didn't have time to launch their own exchange before the 2014 Open Enrollment Period, so they bumped it back a year. Idaho is about to lose that unique status, however, in a big way.

Back in March, the House Democrats held a press event in which they officially rolled out the "Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act", or #PPECMHMAA for short. That's a simply terrible title and an even worse hashtag, so I've simply shorthanded it as #ACA2.0.

The bill is actually a suite of a dozen smaller bills. Nearly all of them are sponsored purely by Democrats, which isn't surprising...but there's one exception:

I was surprised to realize that I haven't written a word about Wisconsin since before the midterm election last fall, when Democrat Tony Evers defeated Republican incumbent Scott Walker. Since then, the state has actually gone through a lot of turmoil regarding healthcare policy (and every other policy as well, of course). The GOP still controls both the state House and Senate, so during the lame duck session they tried to pull a whole mess of crap legislation to strip Evers of his authority before he even took office...as well as that of incoming Democratic state Attorney General, Josh Kaul, to prevent him from withdrawing from the plaintiff's side in the #TexasFoldEm lawsuit, among other things.

Lawsuits were filed, and a judicial tug of war has since ensued, and the last I heard, the state Supreme Court (which leans conservative by one vote) held a hearing over the mess. I'm not sure if they've issued their final ruling yet. 

In the 5 1/2 years that I've been running this website, I've received several honors and accolades, ranging from interviews and profile pieces, to being a finalist in the National Institute for Health Care Management (NIHCM) digital media awards, to even having my work included in not one, but two comic books.

Today I'm honored and humbled to note that I've now had...my portrait painted for an art exhibit. No, seriously.

I wrote about Theresa BrownGold a few months ago:

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